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August 2004

From: Merck / Schering-Plough Pharmaceuticals

Dear Pharmaceutical Purchaser:

             Merck/Schering-Plough Pharmaceuticals (MSP) is pleased to introduce VYTORIN (ezetimibe/simvastatin) Tablets, the first and only product that inhibits both cholesterol production and intestinal absorption. VYTORIN contains both the HMG-CoA reductase inhibitor (statin) simvastatin and the cholesterol absorption inhibitor ezetimibe.

Merck/Schering-Plough Pharmaceuticals is a joint venture between Merck & Co., Inc., and Schering-Plough Corporation that develops and markets prescription cholesterol-management medicines in the United States.

In a multicenter, double-blind, placebo-controlled, 12-week study of 1,528 patients with hypercholesterolemia, VYTORIN lowered LDL-C by 52% at the recommended starting dose (10/20 mg) and 60% at the maximum dose (10/80 mg).

VYTORIN is also indicated for the reduction of elevated TOTAL-C and LDL_C in patients with primary (heterozygous familial and nonfamilial) hypercholesterolemia or mixed hyperlipidemia when diet alone is not enough.

VYTORIN is also indicated for the reduction of elevated TOTAL-C and LDL-C in patients with homozygous familial hypercholesterolemia, as an adjunct to to other lipid-lowering treatments (eg, LDL apheresis), or if such treatments are unavailable.

VYTORIN is available in 4 dosage strengths, each containing 10 mg of ezetimibe and 10 mg, 20 mg, 40 mg, or 80 mg of simvastin. VYTORIN should be taken as a single dose in the evening with or without food.

VYTORIN is contraindicated in patients with hypersensitivity to any component of this medication; active liver disease; unexplained persistent elevations of serum transaminases; women who are of child-bearing age (unless highly unlikely to conceive), nursing, or pregnant.

To place an order, please contact your wholesaler. If you have any questions, please contact the Merck Pharmacy/Wholesaler National Account Executive or Schering-Plough Trade Director who is responsible for your account. For any additional questions, please contact the MSP National Service Center at 1-866-637-2501.

Enclosed is the press release announcing the approval of VYTORIN.

Before Dispensing VYTORIN, please read the enclosed Prescribing Information.


Adam H. Schnechter

Vice President and General Manager

Merck/Schering-Plough Pharmaceuticals

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